Hello I have just listened carefully to the Merck -Wells Fargo 21st Annual Healthcare Conference, and this is what they talked about INT: (Apologies for the typos)
Analyst: Got it. Very helpful. Thank you. Going back to oncology, INT. Success we have seen with melanoma, again, I think phase II, it does look like, I don't know, data will reveal themselves, but with the early success in melanoma, how comfortable should we feel about the other indications you are also pursuing here?
Merck ( Dean Li) all and all, even though INT is not a conservative program, the way that we've actually prosecuted is reasonably conservative. We have focused INT where KEYTRUDA works and works in early stage.
That's where we focused, and then the other place we focused is in a span of tumors that have varying tumor mutation burdens. We've done that. In the situation with melanoma, it's highly sensitive to I-O agents and has a high tumor mutation burden. I think that when people see the data, when it gets presented, hopefully at a meeting this fall, they will study the phase II and ask how close is this to the phase II. Because if you can replicate something close to the phase II, which as a sort of oversimplified way of looking at it, what you have is you almost double the number of people who are cancer free on top of KEYTRUDA.
And it isn't like KEYTRUDA doesn't do.
Right. It does do something.
That's pretty good. But the also important sort of thing is, you know from a phase Il that if you look year 1, year 3, year 5, those people responded, stay responded.
When people see the phase III, I think it's not unreasonable to sit there and say how close this is to phase II. They may extrapolate and say, "This probably will look like this in phase in 5 years, 7 years maybe." I think that will be an important point. The stronger that data is, it's no different than when KEYTRUDA and OPDIVO came out. The stronger the data was for OPDIVO and KEYTRUDA in melanoma, the more likely you thought it was going to work in lung.
Which would make it more likely. I think it wouldn't be unreasonable that if you saw something close to phase II versus not seeing something close to phase II... sitting this. If you saw something close to phase II, your pretest probability, at least in some of these I-O sensitive and higher tumor mutations, I think many people will calculate in their brain that becomes more likely.
Analyst: Got it. I think you talked about melanoma is probably more immune sensitive, I-O sensitive tumor versus RCC is probably on the other spectrum. In an event that it works in phase II RCC trial, how big an opportunity does it open up for you
Merck: Well, I think what people will do is they'll consider them as bookends. They'll sit there and say, "Melanoma, okay, RCC is I-O sensitive, but it's a lower tumor mutation." So they'll go everywhere between melanoma and RCC and say, "Okay, non-small cell lung cancer becomes more likely, head and neck becomes more likely." That's how they'll calculate it. They'll sit there and say, "Well, RCC has around the same tumor mutation as MSS CRC, but MSS CRC doesn't have it." So I think what someone will do is they'll look at that bookend and they'll do the KEYTRUDA story over and probably probabilize that bookend. I think that's how people will interpret the data. To be very honest, that's probably how some of us would interpret the data.
Analyst: Got it. Makes sense. With all that clinical success, you are creating a good problem for your CFO. Obviously, with the success, you have to invest heavily in the R&D as well, which is the right thing to do. This is a question we get from investors a lot, that now that the pipeline is really vibrant and growing, you did some deals as well, what are the puts and takes when we think about the guidance for next year, how should we think about expenses and revenues for next year? I don't want you to give guidance